The Challenges of Antimicrobial Resistance in Brazil

Brazil is a country with continental proportions with high geographic and economic diversity. Despite its medical centers of excellence, antimicrobial resistance poses a major therapeutic challenge. Rates of methicillin-resistant Staphylococcus aureus are up to 60% and are related to an endemic Brazilian clone. Local resistance to vancomycin in Enterococci was first related to Enterococcus faecalis, which differs from European and American epidemiology. Also, local Klebsiella pneumoniae and Escherichia coli isolates producing extended-spectrum beta-lactamases have a much higher prevalence (40%-50% and 10%-18%, respectively). Carbapenem resistance among the enterobacteriaceae group is becoming a major problem, and K. pneumoniae carbapenemase isolates have been reported in different states. Among nonfermenters, carbapenem resistance is strongly related to SPM-1 (Pseudomonasaeruginosa) and OXA-23 (Acinetobacter baumannii complex) enzymes, and a colistin-only susceptible phenotype has also emerged in these isolates, which is worrisome. Local actions without loosing the global resistance perspective will demand multidisciplinary actions, new policies, and political engagement.

Pt(II) and Ag(I) complexes with acesulfame: Crystal structure and a study of their antitumoral, antimicrobial and antiviral activities

Two new complexes of platinum(II) and silver(I) with acesulfame were synthesized. Acesulfame is in the anionic form acesulfamate (ace). The structures of both complexes were determined by X-ray crystallography. For K(2)[PtCl(2)(ace)(2)] the platinum atom is coordinated to two Cl(-) and two N-acesulfamate atoms forming a trans-square planar geometry. Each K(+) ion interacts with two oxygen atoms of the S(=O)(2) group of each acesulfamate. For the polymeric complex [Ag(ace)](n) the water molecule bridges between two crystallographic equivalent Agl atoms which are related each other by a twofold symmetry axis. Two Agl atoms, related to each other by a symmetry centre, make bond contact with two equivalent oxygen atoms. These bonds give rise to infinite chains along the unit cell diagonal in the ac plane. The in vitro cytotoxic analyses for the platinum complex using HeLa (human cervix cancer) cells show its low activity when compared to the vehicle-treated cells. The Ag(I) complex submitted to in vitro antimycobacterial tests, using the Microplate Alamar Blue (MABA) method, showed a good activity against Mycobacterium tuberculosis, responsible for tuberculosis, with a minimal inhibitory concentration (MIC) value of 11.6 mu M. The Ag(I) complex also presented a promising activity against Gram negative (Escherichia colt and Pseudomonas aeruginosa) and Gram positive (Enterococcus faecalis) microorganisms. The complex K(2)[PtCl(2)(ace)(2)] was also evaluated for antiviral properties against dengue virus type 2 (New Guinea C strain) in Vero cells and showed a good inhibition of dengue virus type 2 (New Guinea G strain) replication at 200 mu M, when compared to vehicle-treated cells. (C) 2010 Elsevier Inc. All rights reserved.

Characterization and Identification of Proteolytic Bacteria From the Gut of the Velvetbean Caterpillar (Lepidoptera: Noctuidae)

The characterization and identification of proteolytic bacteria from the gut of the velvetbean caterpillar (Anticarsia gemmatalis) were the objectives of this study. Twelve aerobic and anaerobic isolates of proteolytic bacteria were obtained from the caterpillar gut in calcium caseinate agar. The number of colony forming units (CFUs) of proteolytic bacteria was higher when the bacteria were extracted from caterpillars reared on artificial diet rather than on soybean leaves (1.73 +/- 0.35 X 10(3) and 0.55 +/- 0.22 X 10(3) CFU/mg gut, respectively). The isolated bacteria were divided into five distinct groups, according to their polymerase chain reaction restriction fragment-length polymorphism profiles. After molecular analysis, biochemical tests and fatty acid profile determination, the bacteria were identified as Bacillus subtilis, Bacillus cereus, Enterococcus gallinarum, Enterococcus mundtii, and Staphylococcus xylosus. Bacterial proteolytic activity was assessed through in vitro colorimetric assays for (general) proteases, serine proteases, and cysteine proteases. The isolated bacteria were able of hydrolyzing all tested substrates, except Staphylococcus xylosus, which did not exhibit serine protease activity. This study provides support for the hypothesis that gut proteases from velvetbean caterpillar are not exclusively secreted by the insect cells but also by their symbiotic gut bacteria. The proteolytic activity from gut symbionts of the velvetbean caterpillar is suggestive of their potential role minimizing the potentially harmful consequences of protease inhibitors from some of this insect host plants, such as soybean, with implications for the management of this insect pest species.

Aspectos microbiológicos da bile de pacientes com suspeita de coledocolilitíase e suas repercussões no tratamento das infecções biliares

A infecção das vias biliares é uma doença freqüente com alta morbidade e mortalidade, que pode variar de 10 a 60% dependendo de sua gravidade. A causa mais comum desta infecção é a presença de cálculos na via biliar principal que propicia o surgimento de bacteriobilia. O profundo conhecimento das características microbiológicas da bile nos casos de coledocolitíase e infecção das vias biliares são fundamentais para o melhor diagnóstico desta infecção e escolha da antibioticoterapia a ser instituída. Assim, o objetivo deste estudo foi de caracterizar os principais aspectos microbiológicos da bile dos pacientes com e sem coledocolitíase e avaliar sua importância na escolha dos antimicrobianos para o tratamento da infecção das vias biliares. Foram analisados 33 pacientes que foram divididos em um grupo de 10 pacientes sem coledocolitíase (grupo controle) no momento da Colangiografia Endoscópica (CPER) e em outro grupo de 23 pacientes com coledocolitíase. A bile de todos os pacientes foi coletada no início do procedimento endoscópico, através de catater introduzido na via biliar. O exame de microscopia direta com coloração de Gram e as culturas da bile foram negativas nos 10 pacientes que não apresentaram coledocolitíase durante a CPER. Dos 23 pacientes com cálculos na via biliar principal, 19 (83%) apresentaram culturas positivas. Desses 19 pacientes com culturas de bile positivas, 18 (94,7%) apresentaram microorganismos detectáveis à microscopia direta com coloração de Gram. Apenas um paciente apresentou crescimento de germe anaeróbio (Bacteroides fragilis). O cultivo de 28 bactérias teve predominância de microorganismos Gram negativos (18 bactérias- 64,3%). Os germes isolados foram E. coli (9, 32,1%), Klebsiella pneumoniae (5, 17,9%), Enterococcus faecalis (5, 17,9%), Streptococcus alfa-haemoliticus (3, 10,7%), Streptococcus viridans (2, 7,1%), Enterobacter cloacae (2, 7,1%), Panteona aglomerans (1, 3,6%) e Pseudomonas aeruginosa (1, 3,6%). Todos os pacientes com microorganismos detectados pela microscopia direta com coloração de Gram tiveram crescimento bacteriano em suas culturas, por outro lado nenhum paciente com cultura negativa apresentou microoorganismos à microsopia direta ( p= 0,0005). Nesses casos, a microsopia direta apresentou uma especificidade de 100% e sensibilidade de 80%. A análise quantitativa das culturas da bile mostrou que das 19 culturas positivas, 12 (63,2%) tiveram pelo menos um germe com contagem superior a 105 ufc/ml. Todas as bactérias Gram positivas isoladas foram sensíveis à ampicilina, da mesma forma que todas as Gram negativas foram sensíveis aos aminoglicosídeos. Os achados deste estudo demonstram uma boa correlação entre a microscopia direta da bile com coloração de Gram e os achados bacteriológicos das culturas da bile coletada por colangiografia endoscópica retrógrada. O esquema terapêutico antimicrobiano tradicionalmente empregado em nosso hospital, que inclui a combinação de ampicilina e gentamicina, parece ser adequado, pois apresenta eficácia terapêutica contra os principais microorganismos responsáveis pela infecção das vias biliares.

Cloro e ozônio aplicados à desinfecção de efluente hospitalar tratado em contadores biológicos rotatórios, com avaliação de efeitos tóxicos em Daphnia similis

Neste trabalho foi avaliado o desempenho do sistema de contatores biológicos rotatórios para a remoção de matéria orgânica de efluente hospitalar e a posterior inativação de coliformes totais, Escherichia coli e Enterococcus sp. com os oxidantes hipoclorito de sódio e ozônio. A toxicidade gerada nos processos de desinfecção foi avaliada em Daphnia similis. Os efluentes hospitalares podem apresentar semelhanças aos efluentes domésticos no que diz respeito à concentração de matéria orgânica, coliformes e pH e ambos são, geralmente, coletados pela rede de esgotos e enviados para mesma estação de tratamento. Contudo, a presença de substâncias como fármacos, desinfetantes e compostos químicos, bem como organismos patogênicos multirresistentes a antimicrobianos podem ocorrer em elevadas contagens nas águas residuárias hospitalares. O sistema biológico de tratamento utilizado nesta pesquisa se mostrou adequado, obtendo-se remoções de matéria orgânica na ordem de 80% em termos de DQO, sendo que no término do experimento atingiu-se 88,5% de remoção de DQO para o tempo de detenção hidráulico de 2,28 horas. Houve a inativação de 1 a 2 unidades logarítmicas para coliformes totais, de 2 a 3 unidades logarítmicas para Escherichia coli e significativa remoção de toxicidade. O desempenho dos desinfetantes hipoclorito de sódio e ozônio mostrou similaridades. Entretanto, ao comparar-se com efluentes domésticos, foram necessárias maiores dosagens para o efluente hospitalar devido ao elevado consumo de oxidante pela presença da matéria orgânica refratária ao tratamento biológico. O processo de desinfecção com hipoclorito de sódio apresentou variabilidade nos resultados, em função da concentração de matéria orgânica, nitrogênio amoniacal e pH do efluente. Para ensaios em bateladas em volumes de amostra de 1 litro, valores de C.t oscilaram entre 20 a 50 mg.min.L-1 para inativação de E. coli. A desinfecção por ozônio também sofreu variações em função da matriz complexa do efluente. A inativação dos organismos somente foi acentuada após adição de 70 a 90 mg.L-1 de ozônio, concentrações estas nas quais se observou grande decaimento na absorbância em UV 254 nm, indicando possivelmente o consumo prioritário de ozônio para outras reações de oxidação, tais como a ruptura de anéis aromáticos e/ou insaturações nas cadeias carbônicas. Efluentes de origem doméstica foram rapidamente desinfetados com ozônio. Os organismos Enterococcus sp. apresentaram decaimento ora semelhante a coliformes totais, ora semelhante a Escherichia coli e ora resistentes frente à ação do desinfetante. Após total inativação de coliformes fecais foram eventua lmente observadas contagens na ordem de 103 UFC.100mL-1 de Enterococcus sp. Dada a prevalência de organismos resistentes a antibióticos que, em função disso, apresentam maior grau de virulência, observou-se que somente o monitoramento de coliformes totais e fecais não seria adequado para a desinfecção e lançamento de efluentes hospitalares. A toxicidade aguda do efluente, verificada em Daphnia similis, aumentou após adição de cloro mas foi reduzida quando houve decloração com tiossulfato de sódio. Com adição de ozônio, verificou-se variabilidade nos resultados, mas geralmente houve aumento da toxicidade após aplicação de elevadas dosagens as quais foram necessárias para desinfecção.

Avaliação da atividade antibacteriana de extratos de llex paraguariensis A.St. Hill. ("Erva mate") frente a bactérias zoonóticas em saúde e produção animal.

Motivado pelo cultivo de erva mate no Rio Grande do Sul, basicamente dentro de unidades de produção familiar, bem como pelo considerável volume de biomassa descartada, resultante do corte dos ervais, procurou-se identificar possível atividade antibacteriana em cambitos e folhas de Ilex paraguariensis St. Hill, com ênfase a zoonoses de interesse em saúde e produção animal, bem como em saúde coletiva. Definiu-se a verificação da Intensidade de Atividade de Inibição Bacteriana (IINIB) e Intensidade de Atividade de Inativação Bacteriana (IINAB) de extratos hídricos (decocto), alcoólicos (alcoolatura) e hidroalcoólicos (tintura) sobre inóculos padronizados de Staphylococcus aureus (ATCC 25923), Enterococcus faecalis (ATCC 19433), Samonella Enteritidis (ATCC 11076) e Escherichia coli (ATCC 11229). Os extratos vegetais alcoólicos foram preparados com folhas frescas, os hidroalcoólicos com os talos desidratados (cambitos) e os decoctos, tanto de folhas como de talos, com material desidratado. Todas as quatro formas de extração apresentaram capacidade de inativação e/ou inibição seletivas sobre os inóculos bacterianos, porém os extratos à base de álcool de cereais foram os que apresentaram os melhores resultados. Dentre as bactérias, a Salmonella Enteritidis demonstrou maior sensibilidade, seguida por Enterococcus faecalis. Posteriormente, estas duas amostras foram submetidas a testes sob tempo de exposição de 5, 15, 30 e 60 minutos, na ausência e na presença de matéria orgânica (soro bovino inativado), confrontando-as com alcoolatura de folhas e hidroalcoolatura de cambitos, por estes terem obtido maior ação antibacteriana sobre os agentes testados nos testes iniciais de IINIB e IINAB. Os decoctos de cambitos não corresponderam às expectativas iniciais, sendo que as alcoolaturas, tanto de folhas quanto de cambitos, apresentaram resultados eficazes. Tanto o tempo de exposição como a presença de matéria orgânica interferiram na sensibilidade apresentada por Salmonella Enteritidis e Enterococcus faecalis, positiva e negativamente, respectivamente.

Avaliação das condições higiênico-sanitárias da produção de refeições à base de carne da alimentação escolar no município de Natal-RN

The National School Nutrition Program is the oldest program in the country directed at food and nutrition safety. Its aims are to offer nutritional food as a supplement to students of public and philanthropic schools. Studying school nutrition transcends the investigation as a purely social program, given that it reaches the fields of public health, nutrition and food, using a wide variety of approaches. Thus, it is characterized by a multidisciplinary study, where the disciplines work side by side in distinct aspects of a single problem. Aim: This study aims to assess hygiene practices during the preparation of meat-based meals in public schools in the city of Natal, Brazil. Methods: A list was applied at 27 schools to identify the procedures of good food preparation practices. In addition, cooking and meal distribution temperature were measured and a microbiological analysis of the final preparation and of the water used in preparing it was performed. For microbiological analyses of the food, we analyzed coliforms at 45°C, coliforms at 35°C and Enterococcus, and for the water, we analyzed thermotolerant coliforms and total coliforms, using the methods recommended by APHA, 1995. Results: Most of the schools did not meet the required standards in all the variables related to good food preparation practices, except for the time spent preparing the meat, in which 89% were within the norm. Cooking temperature of the meals was within the standard; however, the temperature at distribution and the time spent dispensing the meals were inadequate. Of the 27 schools, 22 (81.5%) showed the presence of coliforms at 35° C in at least one meal sample and 18 (66.7%) had values above the recommended limit for coliforms at 45°C. The presence of E. coli was identified in 6.1% of the samples analyzed. The presence of Enterococcus was not found at any of the schools. With respect to the water, the North district of the city was the only one that did not meet the standards for the two indicators evaluated. The contamination found was not associated with the hygiene or food storage problems observed. Conclusions: The results show that the hygiene-sanitary conditions of meat-based public school meals were unsatisfactory, demonstrating the need for improvements in the production process to preserve the health of the student population. Multidisciplinarity: Researchers from the areas of food microbiology, nutrition, public health and statistics took part in this study, a decisive factor for characterizing the research as multidisciplinary

Haematologic and immunologic parameters of bullfrogs, Lithobates catesbeianus, fed probiotics

The effects of two probiotics (P(1) - Lactobacillus acidophilus, Bifidobacterium bifidum and Enterococcus faecium and P(2) - Bacillus subtilis) supplemented to commercial feed (40% crude protein) on the haematological and immunological parameters of the bullfrog Lithobates catesbeianus were studied. Two doses of each probiotic (5 and 10 g kg-1 of food) were added to the diets and fed to frogs, totalling five treatments over 112 days. Haematological analyses consisted of total and differential leucocyte counts, erythrocyte and thrombocyte counts, haematocrit, haemoglobin levels and RBC indices (mean corpuscular volume, mean corpuscular haemoglobin - and mean corpuscular haemoglobin concentration) and the immunological parameters included phagocytic capacity and phagocytic index of peritoneal phagocytes. The results showed that the probiotics did not significantly influence any of the haematological parameters measured. However, immunological assays showed that the probiotics had an immunostimulating effect. The greatest effects were seen with probiotic P(1) fed at a dose of 10 g kg-1 of diet and probiotic P(2) fed at 5 g kg-1 of diet.

Decaimento bacteriano em lagoas de estabilização no Nordeste brasileiro

Stabilization pond system consisting in more sewage treatment used in Rio Grande do Norte (RN), Brazil, representing about 90% of all systems. Fecal bacteria are removed mainly facultative ponds and in maturation ponds. Many factors influence bacterial decay, such as the levels of pH and DO, temperature, light intensity, HDT and nutrient availability. The bacterial decay rate (Kb) is calculated considering many variables, but the hydraulic regime is a significant influence for microorganisms removal, and the dispersed flow which best characterizes a stabilization pond. However, some authors developed equations for the Kb accordant plug flow and complete mixing. This research study aimed to evaluate the bacterial decay of fecal coliform and Enterococcus sp. in stabilization ponds designed to treat domestic sewage, full-scale, in RN. All systems have assessed pretreatment, a facultative pond (LF) followed by two maturation (LM1 and LM2). The parameters availed were: temperature, pH, DO, BOD5, COD, fecal coliform, Enterococcus sp., Chlorophyll a, total suspended solids, fixed and volatile. In general, there were not significant differences for pH, DO and temperature in the ponds, except for the new systems, since they have low flow and hydraulic loads. The removal of organic matter in the ponds was low, about 70%, and nearly all are overloaded organic and operational problems. The bacterial removals were low, with average 96% for LF for fecal coliform, and 98% for Enterococcus sp.; LM1 were in itself a removal for fecal coliform about 71%, and 81% for Enterococcus sp.; LM2 have efficiency of 69% for fecal coliform, and 68% for Enterococcus sp. The equation proposed by Von Sperling (1999), according to the dispersed flow regime, generated empirical values of Kb more approximate to calculated values of Kb. On average, the calculated Kb to coliforms in the LF was 0.31 d-1, and for both maturation ponds were 0.35 d-1. For Enterococcus sp. the average was 0.40 d-1 for LF, 0.55 d-1 for LM1, and 0.58 d-1 for LM2. These results also showed that the Kb obtained in full-scale systems are smaller than those found in pilot-scale ponds. Moreover, one can say that the equation proposed by Marais (1974), according to the complete-mix regime, overestimates Kb. Actual results of Kb indicated that fecal coliforms are more resistant to adverse conditions present in stabilization ponds than Enterococcus sp., therefore, an indicator of microbiological safety and efficiency. The factors significant interventions in the rate of bacterial decay were concentrations of COD, the organic loading and HDT. The few Kb relationship between pH, DO and temperature were not significant. Finally, we conclude that it s essential to correct operation and maintenance, for not performing these activities is one of the main factors contributing to low rates of bacterial decay.

Effects of a novel fermented soy product on the serum lipids of hypercholesterolemic rabbits

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of a ferment soy product on the adipocyte area reduction and dyslipidemia control in hypercholesterolemic adult male rats

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fermented soy product supplemented with isoflavones affects adipose tissue in a regional-specific manner and improves HDL-cholesterol in rats fed on a cholesterol-enriched diet

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of ingestion of soy yogurt on intestinal parameters of rats fed on a beef-based animal diet

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of a probiotic soy product on fecal microbiota and its association with cardiovascular risk factors in an animal model

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Aspectos sensoriais e físico-químicos de “iogurtes” de soja com espessantes/estabilizantes a base de fécula de inhame (Dioscorea alata), amido modificado e gelatina

This study had as objective to evaluate the effect of yam starch, modified starch from Cargill-Brasil (Amidomax 4800 (R)) and gelatin from Gelita-Brasil (GEL-LAC) as stabilizers/thickeners in different ratios and combinations in the soy yoghurt fermented with Enterococcus faecium and Lactobacillus helveticus ssp jugurti. Ten soy yoghurt formulations containing these different stabilizers/thickeners, always totalizing 0.5% in relation to the final formulation, were analyzed in sensorial and physical-chemical terms. Based on the observed results, it was concluded in relation to the sensorial point of view that the more appropriate product was processed only with gelatin at 0.5% concentration. This product also presented the best physical-chemical results related to consistency, syneresis and water holding capacity. However, the isolated use of gelatin increased fermentation time of the soy yoghurt.